党中勤从肝辨治胆石症

党中勤教授治疗胆石症多从肝辨治,以正本清源,确立"疏肝利胆、理气通腑、清热利湿、消石排石"的治疗大法,自拟"利胆排石方"作为治疗胆石症的基础方。临证时,党教授常根据患者具体临床表现和病情发展转归不同阶段,辨证与辨病相结合,灵活加减运用。若结石直径较大者,加牡蛎、半边莲、石见穿等;右胁疼痛较甚,或放射至后背疼痛者,加徐长卿、鸡矢藤、姜黄等;腹胀者,加枳实、厚朴、大腹皮等;便秘者,加火麻仁、桃仁、大黄等;便溏者,加茯苓、炒白术、炒薏苡仁、炒山药等;纳差者,加焦麦芽、砂仁;失眠者,加炒酸枣仁、柏子仁、夜交藤等。若肝胆湿热偏重者,加茵陈、虎杖、栀子、大黄、车前子等;肝郁化火明显者,加栀子、黄芩、夏枯草、大黄等;若火郁日久,耗伤阴津者,加生地黄、白芍、知母等;若瘀血明显者,加五灵脂、蒲黄、白芍、莪术等;肝气乘脾者,加陈皮、防风、炒白术等;若肝气犯胃明显者,加陈皮、半夏、生姜等。

Dang Zhong-qin′s Experience of Treating Cholelithiasis from the Liver

Professor Dang Zhong-qin treats cholelithiasis from the liver.He has established the treatment method of"soothing the liver and gallbladder,regulating qi and clearing the viscera,clearing heat and dampness,and removing stones",and adopted Self-made Gallbladder-Promoting and Calculus-Discharging Decoction as the basic formula for the treatment of cholelithiasis.According to the patient′s specific clinical manifestations and different stages of disease development,Professor Dang often combines syndrome differentiation and disease differentiation,and uses them flexibly.For the stone with larger diameter,Muli(Concha Ostreae),Banbianlian(Herba Lobeliae Chinensis),Shijianchuan(Herba Salviae Chinensis),etc.can be added.For patients with severe pain in the right flank or pain radiating to the back,Xuchangqing(Radix Cynanchi Paniculati),Jishiteng(Herba Paederiae),Jianghuang(Rhizoma Curcumae Longae),etc.can be added.For abdominal distension,Zhishi(Fructus Aurantii Immaturus),Houpo(Cortex Magnoliae Officinalis),Dafupi(Pericarpium Arecae),etc.can be added.For constipation,Huomaren(Semen Cannabis),Taoren(Semen Persicae),Dahuang(Radix et Rhizoma Rhei),etc.can be added.For loose stool,Fuling(Poria),fried Baizhu(Rhizoma Atractylodis Macrocephalae),fried Yiyiren(Semen Coicis),fried Shanyao(Radix Paeoniae Alba seu Rubra),etc.can be added.For poor appetite,scorch-fried Maiya(Fructus Hordei Germinatus)and Sharen(Fructus Amomi)can be added.For insomnia,fried Suanzaoren(Semen Ziziphi Spinosae),Baiziren(Semen Platycladi),Yejiaoteng(Caulis Polygoni Multiflori),etc.can be added.For excessive dampness and heat in liver and gallbladder,Yinchen(Herba Artemisiae Scopariae),Huzhang(Rhizoma Polygoni Cuspidati),Zhizi(Fructus Gardeniae),Dahuang(Radix et Rhizoma Rhei),Cheqianzi(Semen Plantaginis),etc.can be added.For obvious liver depression turning into fire,Zhizi(Fructus Gardeniae),Huangqin(Radix Scutellariae),Xiakucao(Spica Prunellae),Dahuang(Radix et Rhizoma Rhei),can be added.For long-time stagnant fire consuming yin and fluid,Shengdihuang(Radix Rehmanniae),Baishao(Radix Paeoniae Alba),Zhimu(Rhizoma Anemarrhenae),etc.can be added.For severe blood stasis,Wulingzhi(Faeces Trogopterori),Puhuang(Pollen Typhae),Baishao(Radix Paeoniae Alba),Ezhu(Rhizoma Curcumae),etc.can be added.For liver qi invading spleen,Chenpi(Pericarpium Citri Reticulatae),Fangfeng(Radix Saposhnikoviae),fried Baizhu(Rhizoma Atractylodis Macrocephalae),etc.can be added.For liver qi invading stomach,Chenpi(Pericarpium Citri Reticulatae),Banxia(Rhizoma Pinelliae),Shengjiang(Rhizoma Zingiveris Recens),etc.can be added.